瑞舒伐他汀对不同血脂、C反应蛋白水平的不稳定型心绞痛患者颈动脉粥样硬化斑块的影响  

Effect of rosuvastatin calcium on carotid atherosclerotic plaques in unstable angina patients with different lipid and C-reactive protein levels

作　　者：张环[1] 赵志敬[2] 吴冠吉[1] 

机构地区：[1]西安市中心医院心内科,陕西西安710003 [2]第四军医大学西京医院心内科,陕西西安710032

出　　处：《心脏杂志》2014年第3期289-292,共4页Chinese Heart Journal

摘　　要：目的:探讨瑞舒伐他汀对不同血脂、C反应蛋白(CRP)水平的不稳定型心绞痛(UAP)患者颈动脉粥样硬化斑块的影响。方法:测定60例UAP患者低密度脂蛋白胆固醇(LDL-C)、超敏CRP(hsCRP)水平,并以LDL-C和hsCRP中位数水平为基础将受试者分为4组,所有入选患者口服瑞舒伐他汀10 mg/d,治疗12个月,分别于治疗前及治疗后3、6、9和12个月时测定三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、LDL-C、hsCRP水平,以及颈动脉中层厚度(IMT),并计算颈动脉斑块积分。结果:经瑞舒伐他治疗9个月,高LDL-C,高hsCRP组颈动脉斑块积分较治疗前下降(P<0.05),治疗12个月时下降更为显著(P<0.01);并且,高LDL-C低hsCRP组颈动脉斑块积分下降程度不如低LDL-C高hsCRP组明显;而低LDL-C低hsCRP组颈动脉斑块积分与治疗前相比无统计学意义。结论:hsCRP的检测可以作为是否进行他汀类药物治疗的参考指标,尤其是对于那些LDL-C降至正常水平的患者。AIM To investigate the effect of rosuvastatin calcium on carotid atherosclerotic plaques inunstable angina patients with different lipid and C-reactive protein levels. METHODS： Low-density lip-oprotein cholesterol （LDL-C） and high-sensitivity C-reactive protein （hsCRP） were measured in 60 pa-tients with unstable angina who were stratified into four groups on the basis of median LDL-C and medianhsCRP levels. All patients were treated with rosuvastatin calcium 10 mg/day for 12 months. Triglyceride（TG） , HDL-C, LDL-C and hsCRP were measured before and 3, 6, 9 and 12 months after treatment.During the same period, carotid intima-media thickness （IMT） was measured and carotid plaque scorewas calculated. RESULTS： Compared with the data before treatment, carotid plaque score decreased at9 months after treatment （ P 〈 0. 05 ） and decreased significantly at 12 months （ P 〈 0. 01 ） in patientswith elevated levels of LDL-C and hsCRP. However, rosuvastatin was also highly effective in reducing thecarotid plaque score in patients with low LDL-C levels but elevated levels of hsCRP. No significantchange was found in patients with low LDL-C and low hsCRP. CONCLUSION： hsCRP screening mayprovide a method to improve the targeting of statin therapy, particularly in patients with low to normal lev-els of LDL-C.

关 键 词：瑞舒伐他汀 低密度脂蛋白胆固醇 超敏C反应蛋白 粥样硬化斑块 

分 类 号：R541.4[医药卫生—心血管疾病]